ACL injury

[Rivière]

I know nobody here is a doctor, and nor do I expect an answer but I thought I'd ask anyway.

Long story slightly shorter... the gym I work at requires us to teach classes. I teach 2 per shift. So 6 classes. 4 of the 6 classes require a lot of leg work. One requires none, and the other requires at least some. On top of this I also do my own leg exercises to keep up with fitness. That's a whole bunch of leg exercise. Needless to say I've been overworked because of the amount of classes I've had to teach, and trying to keep up with my own level of fitness.

At one point around last month I was doing some leg exercises that were reasonably heavy and I felt something 'go' in my right knee. I wobbled and there was pain, but me being stupidly me, I carried on. I ignored all the problems and signs of wear and then last week, I decided to do some night cleaning (a PT is leaving and is useless at work) on some equipment. I came home that night and I noticed my knee was clicking every time I went up the stairs.

I managed to get a doctor's appointment and saw the doctor today.

She assessed my knee and she said I have an issue with my Anterior Cruciate Ligament. I knew I'd injured a ligament but I wasn't sure which. An ACL injury is the most common type of knee injury.

I don't have pain in the knee joint when I move it but it does click when I have to add pressure when stepping or doing things like squats or lunges etc. The doctor said with something like this, it may have flicked out of place and can take 2-3 months to repair. I've visited Dr. Google in case it may have been torn/partially torn and apparently people with tears generally feel pain... so in a way that's good.

However, I need to continue keeping up with exercise due to the nature of my work. Has anyone ever had an ACL injury or know of anyone who has? Do you know of any recovery exercises that may help?

I suppose it's ironic considering the nature of my work, however, with something like this, it's beyond my scope of practice and comes under sports rehab and I have no idea how one would even go about sorting it.

The doctor has referred me to the orthopaedist and marked my case as urgent, however, due to the pandemic, it will take some time before I can be seen.

[Stacey]

I am not a health care professional but I have worked in physio/chiro/healthcare clinics for the last 10 years and these are the things I have been taught to recommend to clients with suspected ACL/knee injuries while we wait to get them in for an appointment.

- Elevate as much as possible, especially if there is swelling.
- Ice
- Compression - bandages, or compression sleeve knee "braces"
- Avoid putting too much weight on only that leg, since you need to continue to exercise, try not to do exercises that make you bear weight on that leg, and if at all possible, avoid exercises that are hard on your knees.
- If you have the means to do so, see a physiotherapist, athletic therapist.
- ACL injuries cause instability in the knee so working on keeping/building strength in your thighs/quads/hamstrings will be helpful.
- If you have to keep teaching/exercising, do your best to ice/rest/elevate in between.

[Rivière]

Thanks ever so much for your response!

I spoke to my manager and he pretty much suggested ignoring the doctor entirely and claimed it 'probably isn't the ACL'. Though I'm inclined to believe a doctor over my manager who hasn't spent years studying and working as a doctor. He did suggest something my doctor also said, which is that the NHS doesn't cover sports injuries like this so I'd have to pay privately. He suggested a couple of places that are very good, though this is just his opinion on it. I want to see if I can get an appointment somewhere asap, though I worry about the cost.

I'm trying to think of exercises that can continue to allow me to keep muscle and protect my knee, but also won't cause any harm. Sadly a lot of quadriceps exercises bar some such as leg raises, mostly involve an action at the knee, or at least something isometric.

[.Brittany.]

I have personally had an ACL tear due to soccer, it's definitely painful. I agree with what Stacey has said above in regards to helping until it gets better. However, something I found helpful was wearing a knee brace or stability tape.

Honestly, I would listen to your doctor and not your manager. The way I see it, your doctor has your HEALTH in mind and as you mentioned went to school for medicine, whereas your manager cares about his company and not wanting you to be off. I'm concerned if you don't take care of it, you might end up with a more severe injury.

As for the clicking, I always have had a grinding noise in my knee when I'm either going up stairs or getting up. It's become a normal part of life.

I hope you feel better soon!

[Silvan]

Hey Sarah, I'm sorry to hear you're going through all this. It must be tough, not only because of the nature of your work but also because your health is concerned and the injury may lead to other problems. I don't have any knowledge that could be helpful, but I hope you'll be able to resolve the situation, see competent health professional(s) and recover as quickly as possible. Your health is of utmost importance. Give yourself space and time to rest

[Rivière]

Thank you both very much. I have taken my manager's suggestions under advisement and am arranging to see a sports therapist. However, I also want to keep in mind that a doctor has told me I have an ACL-related injury - somebody who has sent years and years studying and experiencing all kinds of medical things.

I will definitely look into a knee brace/support. Hopefully it will be ok to wear under my uniform as I wouldn't be able to use it over the top.

[.Brittany.]

If you’re unable to wear a knee brace under your uniform definitely try the stability tape

[Stacey]

Glad you're trying to get in to see someone! As Britney said, if a brace isn't an option (there are "compression" braces that can sometimes work that are very low profile) try KT/Kinesiology tape. There are many videos on youtube that will teach you how to properly tape for that specific injury.

[Rivière]

An update on this...

I ended up paying for a physiotherapist and they were actually very good. She explained that I didn't have an ACL tear or stretch because there would have been a lot of swelling, and I wouldn't even be able to move. Not to mention my knee joint would be all over the place.

She explained and showed me something which deep down, I think I already knew but chose to ignore - bad posture. I have a flat foot problem and so my knees cave in unless my feet are pointed out. Not good on the knees. Because of this, my job, and the fact I bought a new pair of ill-fitting shoes, my knee cap has slipped out of place because the outer muscle of my thigh is very strong but the inner muscle is too weak to pull it into alignment. This has caused my medial ligament to be under a lot of strain, stretching it and causing a lot of pain.

I've had a couple of ultrasound treatments to help ease the ligament a bit, and a list of exercises I need to perform each day.

I actually feel a lot better though have to be mindful of my knee in the classes I teach because I mustn't squat or do anything else similar. I also can't teach cycle classes or basically do any cardio besides just walking.

[Stacey]

Thanks for updating us Sarah! So glad you saw someone and have figured out what is going on and a course of treatment. Hoping things feel better soon!

[Silvan]

Sarah, it's fantastic that you managed to find such a competent physiotherapist!